Healing Through the Liturgy: the Rites of Pastoral Care Prof. John T.Pless Assistant Professor of Pastoral Ministry and Missions Concordia Theological Seminary "Our age, a time of one-sidedness and experimentation, has set its hopes on many things. It has been hoped that the narrow way might be made broad, either through preaching or through the schools or though the care of souls. Without the care of souls, it was finally said, nothing could be accomplished. Then began such a running and racing and caring of souls that it became evident in a very short time that even this could not make the way broad. It was forgotten that preaching, sacrament, catechization, and also the liturgy take the care of souls in a truly magnificent way. The care of individual souls is dependent on the rapport that results from sermon, sacrament, and catechization." (Wilhelm Loehe, Three Books About the Church) Those words appear as a fitting description of North American church life in our day. In fact they were penned by Wilhelm Loehe well over a century ago in 1845 as he observed the busyness of pastors in Germany. They serve as a fitting preface for our reflection together today on the rites of pastoral care as our age also is an era of "one-sidedness and experimentation that has set its hopes on many things." I need not rehearse with you the uneasiness over liturgy that causes many of our people and our pastors a great deal of restlessness these days. You well know the accusations that have become common place in the last three decades. Liturgy is irrelevant. It is a hindrance to the evangelistic mission of the church. Or as one of Rabbi Abraham Heschel's congregants was reported to have complained to him, "the liturgy doesn't say what I want it to say." The good rabbi, by the way, responded saying "you've got in backwards…are you saying what the liturgy wants you to say?" Liturgy is seen in pragmatic terms of how it is able to stimulate numerical growth or provide a sense of psychological well-being. Those who see liturgy in such terms will, no doubt, have a difficult time making the connection between liturgy and pastoral care. A primary difficulty, it seems to me, is the almost wholesale equation of pastoral care with counseling. E.Brooks Holifield in his book, A History of Pastoral Care in America: From Salvation to Self-Realization shows how American clergy moved to embrace psychology over theology in their efforts to care for the soul. Holifield writes "Sometime after the Civil War, the pastoral theologians lost their sense of balance. By the end of the century they would have little to say about the ideal of balance among the faculties or the notion of pastoral conversation as a balanced appeal to sentiment, reason, and volition. They spoke more often about the vitality of human nature-either the force of the will or the dynamism of the subconscious impulse. They talked about the power and energy, effort and mastery, force of character and boldness of decision, and the 'natural processes' of human life….By 1895 Washington Gladden could announce that the revision was complete: 'Christianity is no longer anti-natural; it is in the deepest sense natural." (E. Brooks Holifield, A History of Pastoral Care in America: From Salvation to Self-Realization) Six years later in 1901, Henry Churchill King of Oberlin would proclaim that "the first and foremost, the constant, the last, and the greatest study of the theologian must be of persons and personal relations." A key theme in many of the text books in pastoral theology emanating out of liberal, American churches was the need for the pastor to be attentive to the psychological and social dynamics of the parish. Henry Ward Beecher advised ministers to multiply picnics and build well-equipped church parlors. Parlors were deemed almost as necessary as pulpits. In his Yale Lectures on Preaching, Beecher would contend "No church ought to be built after this, in city or country, that has not in connection with it either a place set apart as a parlor, or a room which by some change of seats could be made into a parlor. There ought from week to week, or every other week, during the largest part of the year, such little gatherings as shall mingle the people together and make them like one another." William James would make psychology a vital element in pastoral practice in the late 19th and early 20th centuries. Elwood Worchester and Samuel McComb, priests at Emmanual Episcopal Church in Boston founded the Emmanuel Movement in 1905 opting for science over tradition as the guiding force in the care of souls. In 1925, Anton Boisen would found the Clinical Pastoral Education movement at Worchester State Hospital, arguing that theological seminaries needed a thorough -going curriculum shift in order attend to the scientific study of religious experience. Boisen, a graduate of Union Seminary in New York who himself had been hospitalized for mental illness on two occasions, maintained that seminarians ought not limit themselves to the exegesis of biblical texts but instead must engage in the interpretation of "living human documents" within a clinical environment. While Boisen himself upheld strenuous moral standards, those who followed him tended to see emotional distress as rooted in authoritarian religious teachings especially as they had to do with sexuality. "Understanding" was the watchword for the generation of clinical pastoral educators that followed Boisen. This understanding embraced "tolerance, an acceptance of feelings; of the body, the senses, and sexuality; and opposition to rigidity and to condemnation. Understanding implied an ethical attitude, a willingness to sympathize with people rather than idolize conventions and rules." The theological contours of pastoral care were becoming increasingly hard to discern. Attempting to integrate psychological insights into Christian theology and pastoral practice resulted in a theology that was dominated by the categories of current psychological theories. The Gospel was recast in psychological terms. With the rise in popularity of Paul Tillich's theological method of correlation, it was held that Christian theology was compatible with depth psychology. Tillichian language of grace as unconditional acceptance and faith as "accepting that you are accepted" was thought to adequately convey the scriptural message in psychological terms. Carl Braaten aptly summarizes the outcome of this approach "Many of the new professionals thought of themselves as critics of an authoritarian church, opponents of repressive moralism, and enemies of dogmatism. Persons should be free and freeing of others-from moral authoritarianism and institutional impositions. Carl Roger's book, Counseling and Psychotherapy, became a standard text among clinical groups and in theological seminaries. One of the reasons for its popularity was that the counselor could satisfy the impulses of the client seeking self-acceptance and self-realization." (Carl Braaten, Justification: The Article by Which the Church Stands or Falls) Needless to say the traditional liturgical rites of pastoral care had little place in this new configuration. Ritual was seen as something magical, a relic of a past age dominated by priestcraft and supersition. Ritual was seen as antithetical to authentic self-expression. Apart from two passing, historical references, liturgy is not dealt with at all in Stewart Hiltner's 1957 book, Preface to Pastoral Theology. The sacraments likewise are mentioned only in briefly and that in connection to an overview of the history of pastoral care. In American Lutheran circles, William Hulme of Luther Seminary in St.Paul represented the transition from the older, churcly pastoral theology represented in G.H. Gerberding (The Lutheran Pastor, Augsburg, 1902) and the new approach centered in pastoral counseling. Writing in 1981, William Hulme would write that "The Clinical Pastoral Care movement has succeeded to a large extent in exposing the superfical use of the traditional religious resources in pastoral care." (William Hulme, Pastoral Care and Counseling) For Hulme, prayer, scripture, and the sacraments still had a place in pastoral counseling as long as they were set within the context of a genuine, "pastoral encounter." However, at best, they are resources and hardly at the center of the pastor's work..Relationships not ritual seemed to be the order of the day. The call to consider the significance of liturgy in pastoral care would not come from the clergy but rather from a clinical psychologist, Paul Pruyser, of the Menninger Foundation. Writing an chapter entitled "The Master Hand: Psychological Notes on Pastoral Blessing" (Paul Pruyser, in The New Shape of Pastoral Theology: Essays in Honor of Seward Hiltner edited by William B. Oglesby, Jr. ) in the 1969 festschrift for Stewart Hiltner, Pruyser observes that ministers seem to have a hard time with the benediction. Pruyser wonders why it is that many pastors pronounce the benediction without any sense that these words are not a pious wish but an efficacious proclamation of God's own presence. Further he speculates that the diminished place of blessing in the liturgical service is paralleled by the fact that many clergy seem uncomfortable with any rites of blessing in situations of individual pastoral care. Pruyser concludes that Protestant clergy are ill at ease with blessing because they have lost both the doctrine of God's providential care and the understanding that the ministerial office that sees this office as having something more to offer than emotional support or psychological therapy. In 1976, Pruyser would develop this theme in some detail in his book, The Minister as Diagnostician. Here Pruyser calls on pastors to take seriously the fact that they "possess a body of theoretical and practical knowledge that is uniquely their own." (Paul Pruyser, The Minister as Diagnostician) While Pruyser maintains that pastors may benefit from the insights of the psychological sciences, these insights ought not overshadow or diminish the integrity of the theological knowledge that is foundational for pastoral work. Pruyser worries that many clergy have become uncertain of their unique calling and have restlessly looked to psychology for guidance rather than utilizing the legacy of Christian theology. The language of the church is jettisoned for the language of the clinic. In striving to be like counselors, ministers are rendered incapable of providing genuine pastoral care, that is, the care of souls using the means that reside in the pastoral office. The rites of pastoral care presuppose a kerygmatic rather than a therapeutic understanding of the pastoral office. In his lectures in pastoral theology at the seminary of the Confessing Church in Finkenwalde published in English under the title Spiritual Care, Dietrich Bonhoeffer maintains that "caring for the soul is a special sort of proclamation" that is tied to the preaching office. Bonhoeffer is critical of the language of "spiritual direction" that has now become widespread. Bonhoeffer notes that "spiritual direction" is carried out on the human level, between two people as one subjects oneself to the guidance of another. Spiritual care which as Bonhoeffer defines it is pastoral care is "from above", from God to the human being. Bonhoeffer writes: "In spiritual care, God wants to act. In the midst of all anxiety and sorrow we are to trust God. God alone cane be a help and comfort. The goal of spiritual care should never be a change of mental condition. The mission itself is the decisive element, not the goal. All false hope and every false comfort must be eliminated. I do not provide decisive help for anyone if I turn a sad person into a cheerful one, a timid person into a courageous one. That would be secular-and not real-help. Beyond and within circumstances such as sadness and timidity it should be believed that God is our help and comfort. Christ and his victory over health and sickness, luck and misfortune, birth and death must be proclaimed. The help he brings is forgiveness and new life out death." It is this kerygmatic understanding of the pastoral office and therefore of pastoral care that has been diminished in our day. Pastoral care has been confused with works of mercy, support, counsel, and encouragement that ought to be given by every member of the royal priesthood in the context of his or her calling in this world. This confusion is seen in William Hulme who contends that lay people can and must provide pastoral care and counseling and goes so far as to assert "the priesthood of the believer has as its other side of the coin in the pastorhood of the believer." (Hulme, 155-156) Deacons, deaconesses, and others may be commissioned by the church to attend to provide support, assistance, encouragement and the like but this not pastoral care. As God-pleasing and valuable as they works are in the life of the congregation, they ought not be confused with the ministration of the means of grace. Pastoral care is the care that is given by pastors using the means that reside with the pastoral office. Our primary book of pastoral theology is the Agenda. The starting point is the ordination rite. Here the man who is to be ordained pledges faithfulness to the Sacred Scriptures and the Lutheran Confessions. Then, he is asked: Do you solemnly promise that you will perform the duties of your office in accordance with these Confessions, or Symbols, and that all your teaching and your administration of the sacraments will be in conformity with the Holy Scriptures and the aforementioned Symbols? Will you faithfully instruct both young and old in the chief articles of Christian doctrine; will you forgive the sins of those who repent, and will you promise never to divulge the sins confessed to you; will you minister faithfully to the sick and dying; will you demonstrate to the Church a constant and ready ministry, admonishing the people to a lively confidence in Christ? (Commission on Worship of the Lutheran Church- Missouri Synod, Lutheran Worship Agenda) The Agenda provides the rites of pastoral care: individual confession and absolution, visitation of the sick and the homebound, commendation of the dying, burial of the dead etc. The rites of pastoral care assume the centrality of the weekly gathering of God's people around Word and Sacrament in the Divine Service. The ordinary place of ongoing pastoral care is the liturgy itself. William Willimon notes that "for centuries the liturgy actively celebrated, has been the most important form of pastoral care." (William Willimon, Worship as Pastoral Care) All pastoral care radiates from the preaching of the Gospel and the administration of Christ's sacraments. Note, for example, the service for the burial of the dead in the Lutheran Worship Agenda.The burial rite reflects the threefold pattern of separation, transition, and incorporation as it begins in the home (or funeral home), moves to the church, and ends in the cemetery. The rubrics properly note the appropriate location for a funeral for the baptized is the church. In fact, the whole rite ought to be seen as the culmination of Holy Baptism. The pastor in his customary vestments meets the casket and mourners at the door of the church- an act that recalls our Lord's reception of the funeral procession at Nain (Luke 7:11-17). Here the pastor speaks words of comfort and consolation in Christ. Then Romans 6:3-5 is read as the pall is placed on coffin. The words of Romans 6 connect the death and burial of the Christian with his death and burial in Christ in Holy Baptism. The pall recalls the baptismal garment signifying the righteousness of Christ. Likewise the use of the paschal candle points to Jesus Christ, the Light of the world who has enlightened us in Baptism. In the committal service, the relationship to Baptism is once again accented as the pastor says "May God the Father, who created this body, may God the + Son, who by his blood redeemed this body to be his temple, may God the Holy Spirit, who by Holy Baptism sanctified this body to be his temple, keep these remains to the day of the resurrection of all flesh." (Lutheran Worship Agenda, 194) The use of psalmody, scriptures, prayers, hymnody, baptismal imagery, and the possible celebration of the Lord's Supper in the burial rite emanate from the ongoing liturgical life of the church. In using the rites of pastoral care, both pastor and the people are reminded that the care that is being extended is the care of Christ Himself. It is Christ, the Good Shepherd and Heavenly Physician who is present in the midst of sickness and pain, death and grief to speak His words of life and salvation. Thus the rites of pastoral care are not constructed around anthropological themes but around the Word of Christ and its reception in repentance and faith. "Where forgiveness is not, there death reigns" wrote Bonhoeffer. The rites of pastoral care are vehicles for the proclamation of the forgiveness of sins, and where there is the forgiveness of sins there is life and salvation, the Catechism reminds us. The previous generation was suspicious of the place of ritual in pastoral care; today there is a growing recognition that human beings need ritual. Check out the websites of many hospitals and you will no longer find references to chaplains or chapels but "spiritual care centers" or "mind body spirit clinics" where something like the following is offered: Spiritual direction/guidance is a confidential professional relationship that is inclusive and respectful of multi-cultural and interfaith perspectives. The conversation may include meditation, prayer, or other spiritual practices that enhance personal peace, inner calm and hope. It may also include a time to explore what grieves, worries, or frightens you, or what causes you hope, joy, healing, or celebration. It is an opportunity to listen to your life with the reverence and care that it deserves. The focus of the conversation is on the sharing of your story and the movement of your spirit and life experience (University of Minnesota/Fairview Health Services website) The website then goes on to offer the patient assistance in the development of meaningful rituals. Rituals R Us! Where the church's rites of pastoral care are set aside, the vacuum will be filled with a variety of home- made rituals that are lacking the mandatum of Christ and are reflective of human efforts to achieve healing and peace which are always destined to fail. John Kleinig points out that "Every pastor is either a witting or unwitting ritualist." (John Kleinig, "Witting or Unwitting Ritualists" Lutheran Theological Journal (May 1988)) We are confronted not with the question will we use ritual or not, but rather how will we use ritual? Will the rite be used with theological integrity so that the Gospel of Jesus Christ is clearly proclaimed or will the rite be transformed by cultural trends or used for pragmatic purposes to meet what the pastor deems to be the needs of the moment. The salutary use of the rites of the pastoral care requires theological integrity. Surely the theology expressed in the rites must be drawn from the Scriptures and grounded in the Gospel of justification by grace through faith in Christ. But the rite also must be used with theological and pastoral integrity. A recent book entitled The Trivalization of God (Donald McCullough) describes how God and the things of God have been made trival in our culture, not so much by the unbelieving world but by the church itself. Our liturgical repitore is now complete with country western liturgies that invite the faithful to lift up their achy breaky hearts to the Lord and those with a taste for the fifties can use "I found my thrill on Calvary's hill" in place of the Agnus Dei. Nearly every pastor has some horror story to tell relative to weddings and funerals. Editor Russ Saltzmann in the October 2000 issue of Lutheran Forum Letter confesses his recent involvement in a wedding where the bride's dog was the ring bearer. Saltzmann speculates that he will soon have a funeral where bowser is made an honorary pallbearer. Now these stories are the stuff of ecclesiastical malpractice, but they do remind us how deeply sentimentality and the drive toward inclusivity-even of the canine variety- threaten to corrupt the word that the church is attempting to speak at such occasions as marriage and burial. It is more than a matter of bad taste. The misuse of the rites of pastoral care point to a flawed theology, a flawed understanding of God and the character of His saving work. Two brief examples will suffice. A pastor is called to the hospital where a member of his parish had delivered a stillborn child earlier in the day. As he enters the room, the attending nurse offers to bring the corpse to the room so that the pastor can baptize it. Fortunately, the mother is well catechized enough to inform the nurse that such an activity is not necessary. Instead the pastor uses Scripture and prayers from the rite for the burial of a stillborn child in the Agenda. A less than pleasant outcome has to do with a seminarian enrolled in a CPE program. In this particular CPE program, it was made clear that students were to provide whatever rites were requested by the patient. A seminarian who refused to baptize a dead baby was lectured by the supervisor for "being too rigid about the theological theory rather than being empathic to the parents' needs." (Elaine Ramshaw, Ritual and Pastoral Care) Here the doctrine of baptism is set aside in an attempt to provide comfort for grieving parents. In a desperate attempt to soothe the pain that naturally comes with the loss of a child at birth, the chaplain/supervisor reduces baptism to a human ritual to be manipulated in an effort to assist the parents with their grief. However well meaning such an act might be it is a betrayal of the sacrament and of the parents themselves. (I might add that the Lutheran Church of Australia's commission on worship has produced a book entitled Rites of Pastoral Care that does include a well-crafted rite for use with parents at the time of a miscarriage or stillbirth. Pastors will also want to be aware of Luther's "Comfort for Women Who Have Had a Miscarriage" in Luther's Letters of Spiritual Counsel edited by Theodore Tappert and recently reprinted by Regent University Press). In recent years, the long-neglected practice of individual or private confession and absolution has rightfully received renewed attention both from liturgical scholars and pastoral theologians. Theologically, the rite of confession and absolution is an extension of the doctrine of justification. Here in the word of absolution, Christ Himself deals with our sin in forgiveness. What he forgives in and by the word of absolution remains forgiven. This word removes sin from the sinner as far "as the east is from the west" to use the language of the Psalm. In confession, the ear of the pastor becomes the tomb wherein our sin is buried with Christ. And the mouth of the pastor is the mouth of Christ Himself. The forgiveness spoken from human lips is "as valid and certain, in heaven also, as if Christ, our dear Lord dealt with us Himself." In confession and absolution, the pastor is not a Christian friend, counselor, professional church worker, care-giver or therapist but the servant of the Word who listens and speaks in the stead and by the command of Christ. David Wells has observed how clergy have sought professional status. "It is not hard to see why clergy should have embarked on their on movement toward professionalization. After all, that is how other professionals acquired their standing in society. It was by gaining control over their specialized fields that medical doctors, lawyers, architects, accountants, and engineers secured their own space and social standing for themselves. Professionalization, however, is itself a culture, and the values by which it operates are not always friendly to pastoral calling and character. For the most part, American clergy have not understood this. They grabbed at professionalization like a drowning man might grab at a life jacket, but having been thus saved they must now live by its limitations and dictates." (David Wells, No Place for the Truth) This is surely seen when it comes to the practice of confession and absolution. While civil law generally protected the confidential nature of communication between a parishioner and his pastor, some states have recently enacted laws requiring certain professions to report suspected cases of child abuse to the authorities. Clergy, now included in the category of "helping professionals" are included in this statue. Obviously, this poses a problem for the Lutheran pastor who has solemnly promised never to divulge any sin that is confessed to him. Clergy have insisted on being treated like professionals and now the state is recognizing their professional status, but in a way that threatens to compromise the Gospel itself. Where the pastor is viewed as a counselor or therapist the significance of the seal of confession (sigillum confessionis) will naturally be seen only in terms of professional ethics and issues of legality. Bo Giertz rightly observes "Experience shows that in the same measure in which one begins to supplant private confession with private counsel, the respect for the seal of confession grows slack." (Quoted in Fred Precht, "Confession and Absolution: Sin and Forgiveness" in Lutheran Worship: History and Practice edited by Fred Precht ) The 1999 Commission on Theology and Church Relations document, The Pastor-Penitent Relationship: Privileged Communications endangers the integrity of individual confession and absolution as it finally concedes "The vow to keep confidence must be viewed in conjunction with other obligations that also bind the pastor. When a pastor's vow to keep confidences conflicts with other solemn promises he has made, pastoral judgments have to be made by weighing the conflicting and competing interests involved. In a sense, then, the vow of confidentiality does not stand alone as absolute. (Commission on Theology and Church Relations of the Lutheran Church-Missouri Synod, The Pastor Penitent Relationship) With these three sentences, the CTCR has determined that "never" does not always mean 'never' and thus the absolutely binding character of the vow is undercut. Far better is the advice of a German Lutheran pastoral theologian of the last generation, Wolfgang Trillhaas: "But back of this temptation of the pastor to break the seal of silence there is something else. One who really receives and keeps secret what he has learned in the confessional finds that he has been called to bear a burden. A load has been dropped upon him. He may be shocked, digusted, and outraged by what is revealed to him, and he will have to realize again and again that ultimately it is not his own ability to bear burdens that counts. He bears them in Christ's name. He should bear them because Christ took it all upon himself. He should bear them; he must even accept not only the tensions which arise from the understandable temptation to throw off the burden upon others, possibly making it public, but also those which arise from any sort of legal or ministerial obligations. Hearing confession is hard because it can lead the pastor into conflicts of conscience, for which he must be prepared and which he must absolutely endure. (Wolfgang Trillhaas, "The Seal of Confession" in The Minister's Prayer Book edited by John Doberstein) Only where never means never will the practice of individual confession and absolution endure as a genuinely pastoral rite that brings the healing power of forgiveness to souls tormented by sin. The rites of pastoral care must be theologically consistent and constant. Without theological integrity, rites will be molded to be reflective of the perceived needs of the individual or crafted as weapons of ritual self- defense against the God who is to be feared, loved, and trusted above all things. Anchored in the Gospel and Sacraments, the rites of pastoral care are the vehicles of our Lord's gracious presence to bless and sustain, to heal and give life in His name. The Orthodox theologian Alexander Schmemann writes of the church's care of one who is sick, "The Church does not come to restore health to this man, simply to replace medicine when medicine has exhausted its own possibilities. The Church comes to take this man into the Love, the Light, and Life of Christ. It comes not merely to 'comfort' him in his sufferings, not to 'help' him, but to make him a martyr, a witness to Christ in his very sufferings. (Alexander Schmemann, For the Life of the World) Kenneth Korby has described Wilhelm Loehe's understanding of the liturgical life of the congregation as concentric circles that move around Word and Sacrament. (Kenneth F.Korby, Theology of Pastoral Care in Wilhelm Loehe With Special Attention to the Function of the Liturgy and the Laity) Just as planets are in orbit around the sun, so the rites of pastoral care revolve around the Divine Service reflecting the light of Christ's gifts on our living and our dying, hallowing our pain and grief by His holy presence. © Rev. John T. Pless. Used by permission.